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Nakagami Y, Uchino K, Okada H, Suzuki K, Enomoto M, Mizuno S, Yamamoto H, Hanamura I, Nakayama T, Tani H, Takami A. Potential role of Howell-Jolly bodies in identifying functional hyposplenism: a prospective single-institute study. Int J Hematol 2020; 112:544-552. [PMID: 32572828 DOI: 10.1007/s12185-020-02925-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/29/2022]
Abstract
Although patients with cancer and immunosuppression are at a risk of functional hyposplenism, how to detect it promptly remains unclear. Since hyposplenism allows erythrocytes with nuclear remnants (Howell-Jolly bodies [HJBs]) to appear in the peripheral blood, HJB detection by a routine microscopic examination may help identify patients with functional hyposplenism. This prospective study was thus performed to determine the underlying diseases in patients who presented with HJBs. Of 100 consecutive patients presenting with HJBs, 73 had a history of splenectomy. The remaining 27 had hematologic cancer (n = 6, 22%), non-hematologic cancer (n = 8, 30%), hepatic disorders (n = 4, 15%), premature neonates (n = 3, 11%), hemolytic anemia (n = 2, 7%), autoimmune disorders (n = 2, 7%) and miscellaneous diseases (n = 2, 7%), and their prior treatments included chemotherapy (n = 8, 30%), steroids (n = 7, 26%) and molecular-targeted therapy (n = 3, 11%). Among the 27 patients, 22 had computed tomography scans available: 3 (14%) had underlying diseases in the spleen, and the remaining 19 (86%) were all found to have a decreased splenic volume, including 11 (50%) with more than 50% of the ideal value. The present findings suggest that HJB detection identifies patients with potentially functional hyposplenism who should receive appropriate interventional treatment, such as vaccination and prophylactic antibiotics.
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Affiliation(s)
- Yuya Nakagami
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Kaori Uchino
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Hematopoietic Cell Transplantation Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroaki Okada
- Department of Radiology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Kojiro Suzuki
- Department of Radiology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Megumi Enomoto
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Shohei Mizuno
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Hematopoietic Cell Transplantation Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hidesuke Yamamoto
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Hematopoietic Cell Transplantation Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Ichiro Hanamura
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Hematopoietic Cell Transplantation Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Takayuki Nakayama
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroya Tani
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Akiyoshi Takami
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan. .,Hematopoietic Cell Transplantation Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan.
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